Medicaid Cuts Close Hospitals

Medicaid is the single most extensive health insurance program in the U.S. This public program covers 71 million low-income, disabled, and elderly U.S residents, pays for half of all U.S births, and provides care for 6 in 10 nursing home residents. According to the American Hospital Association, Medicaid is one of the most cost-efficient health programs in the U.S.

The Guardian reported that rural hospital will close because of Trump’s budget. An analysis released by the Sheps Center for Health Services Research at UNC Chapel Hill earlier this year revealed that 338 rural hospitals around the country were at risk of imminent closure with cuts to Medicaid in the contained bill.

“It’s going to have to hit them first,” said Laurie Stradley, CEO of Impact Health in Asheville, a Medicaid-funded non-profit providing social services.

The passing of this bill marks over $1 trillion in cuts to Medicaid.  Experts worry that this could pressure Republican-led states to scale back on parts of the program and leave many without access to timely healthcare.

“This is an extraordinarily regressive bill,” said Joan Akler, executive director and co-founder of Georgetown University’s Center for Children and Families. “This is the largest rollback of healthcare coverage that we’ve ever seen and all in service of an agenda to drive tax cuts that will disproportionately benefit wealthy people and corporations.”

For North Carolinians, the Medicaid cut isn’t his bill and could have “particularly acute consequences.” Experts say that this bill could trigger a “kill switch” to end Medicaid expansion. North Carolina began its expansion in December 2023, enrolling more than 650,000 people. All of these residents will lose coverage when this program ends. This group is only a fraction of the 17 million people across the country who are expected to lose health insurance by 2034.

“If the state spends any state dollars to implement the expansion population or expansion coverage, it triggers an automatic ending to Medicaid expansion,” said Kody Kinsley, North Carolina’s former secretary of health.

North Carolina is set to lose $32 billion in federal funding over the next decade.

“Ultimately, Medicaid being cut is going to kill people,” said Molly Zenkler, a nurse at Mission Hospital in Asheville. “I deal with people getting their feet amputated because they don’t have access to diabetic care. This is just going to get increasingly worse.”

Because Medicaid is such an extensive program, deep cuts like this will not only affect the patients but also its rural healthcare providers who are already barely hanging on. For many, their local emergency room is often the only form of healthcare access available to uninsured individuals, as hospitals are legally required to treat them regardless of their ability to pay. This means that they will be forced to restrict services such as obstetrics, behavioral healthcare, and other complex services. The worst case would be closing their doors altogether.

This reconciliation bill not only affects those who receive relief through Medicaid, but it will also increase the cost for those who are privately insured, including those covered through employers. As hospitals struggle to survive on their limited funds, they will extract as much money as possible from various sources of funding, including commercial insurance.